GEORGIA COMPOSITE MEDICAL BOARD · Georgia Composite Medical Board ... LaSharn Hughes, MBA, Interim Executive Director ... Patricia Sherman, Enforcement Manager

Georgia Composite Medical Board

Minutes of the August 10, 2017 Meeting

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The Georgia Composite Medical Board (GCMB) held its regular meeting on August 10, 2017 2 Peachtree Street, 36th Floor, NW, Atlanta, Georgia, to consider Medical Board matters.

Board members present: John S. Antalis, MD, E. Daniel DeLoach, MD, Chair Keisha Callins, MD, MPH Gretchen Collins, MD John Downey, DO Charmaine Faucher, PA-C (ex-officio) Alexander S. Gross, MD by Teleconference J. Jeffrey Marshall, MD, Vice Chair B. K. Mohan, MD David Retterbush, MD Joe Sam Robinson, MD Barby Simmons, DO Ronald “Ronnie” Wallace, MBA Richard Weil, MD

Management and legal staff present: LaSharn Hughes, MBA, Interim Executive Director William Butler, MD, Medical Director Carl Bedingfield, MD, Assistant Medical Director Tara Burks, Operations Manager Kia Hargrove, Licensure Manager Karl Reimers, Deputy Executive Director Patricia Sherman, Enforcement Manager Janet Wray, Senior Assistant Attorney General David Stubins, Senior Assistant Attorney General Doris Williams-McNeely, Sr. Assistant Attorney General

Board Members absent: CALL TO ORDER Dr. Deloach called the meeting of the Georgia Composite Medical Board to order at 7:30 a.m. AGENDA Dr. Retterbush offered a motion to accept the August 10, 2017 agenda. Dr. Robinson seconded the motion and it carried unanimously. EXECUTIVE SESSION Dr. Robinson offered a motion to go into closed session to discuss personnel matters. The motion was seconded by Dr. Retterbush, and it carried unanimously. Upon conclusion of the confidential matters, Dr. DeLoach declared the meeting in open session. RULES HEARING Dr. Weil convened the Public Hearing concerning the following proposed Rules amendments: Rule Chapter 360-15-.01, “Requirements for Physicians.” Dr. Retterbush asked if anyone was present to address the Board on the posted Rules amendments. Bethany Sherrer, MAG made comments opposing mandated CME. After hearing comment Dr. Retterbush made a motion to amend Rule Chapter 360-15-.01, “Requirements for Physicians” and the Board find the formulation and adoption of these rules do not impose excessive regulatory cost on any licensee and any cost to comply with the rule cannot be reduced



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by a less expensive alternative that fully accomplishes the objectives of the applicable laws; that the Board finds that it is not legal or feasible to meet the objectives of the applicable laws to adopt or implement differing actions for businesses as listed in O.C.G.A. 50-13-4(A) (3)(A),(B),(C), and (D). Dr. Marshall seconded the motion, and it carried unanimously. . Rule 360-35-.01, “Definitions.” Dr. Weil asked if anyone was present to address the Board on the posted Rules amendments. No one was present. Dr. Retterbush made a motion to amend Rule 360-3-.07, “Practice through Electronic or Other Such Means.” that the Board find the formulation and adoption of these rules do not impose excessive regulatory cost on any licensee and any cost to comply with the rule cannot be reduced by a less expensive alternative that fully accomplishes the objectives of the applicable laws; that the Board finds that it is not legal or feasible to meet the objectives of the applicable laws to adopt or implement differing actions for businesses as listed in O.C.G.A. 50-13-4(A) (3)(A),(B),(C), and (D). Mr. Wallace seconded the motion, and it carried unanimously. CHAIR’S REPORT Dr. DeLoach thanked the Board members for electing him as Chair. He announced that the Board is under new leadership and welcome LaSharn Hughes as Interim Executive Director. APPEARANCE BEFORE THE BOARD Aubrey Camacho, MD requested an appearance before the Board to request reinstatement of his license. Dr. Camacho addressed the Board with information regarding his quest for reinstatement. The Board members asked Dr. Camacho questions. Dr. Camacho responded. Dr. Retterbush motioned to go into closed session to discuss investigative matters. Dr. Robinson seconded the motion and it carried unanimously. Dr. Deloach declared open session. Dr. Weil motioned to deny request for reinstatement. Dr. Retterbush seconded the motion and it carried unanimously. RECESS Dr. Deloach declared the meeting in recess for the purpose of holding committee meetings. RECONVENE Dr. Deloach reconvened the meeting at 2:16 p.m. INTERIM EXECUTIVE DIRECTOR REPORT 1. Reviewed corrections to the June 8-9, 2017 meeting. Dr. Retterbush motioned to amend the June 8-9, 217 Board minutes. Dr. Mohan seconded the motion and it carried unanimously.. 2. Georgia PHP celebrates five years. For information only. 3. Code Section Review – any old laws and rules the Board needs to change. Board approved to remove Code Section 43-34-124-126 “Patient Qualifications Review Board”. from Board’s Laws.



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4. Medical Association of Georgia – regarding who should sign a death certificate. Board approved a resolution to support the physician regarding signing the death certificate. 5. Board approved Board meeting dates for 2018. January 11, 2018 Board office February 1, 2018 Mercer University, Savannah March 1, 2018 Board Office April 12, 2018 Board Office May 3, 2018 MCG at Augusta University June 7, 2018 Board Office July 12, 2018 Board Office August 2, 2018 Philadelphia College of Osteopathic Medicine, Suwanee September 13, 2018 Board Office October 4, 2018 Board November 8, 2018 Board Office December 6, 2018 Morehouse School of Medicine – Atlanta 6. Reviewed the Committee assignments for 2018. For information only. 7. Discussion Draft: Proposed Regulations for prescription drug monitoring program. Board asked the staff to ask for clarification on Rule S11-7-2.06 8. T.C. submitted an email regarding dispensing RX med – (non-controlled and prepacked/repackaged by an FDA Registered/DEA Registered Repackage).Board will take under advisement for the next Board meeting. 9. Reviewed the Office of Planning and Budget. Instructions for budget FY 2018 and 2019. 10. Article entitled “How doctors can stop the opioid crisis at its source: Quit overprescribing”. For information only. 11. Jeff Murray, Jr. emailed a follow-up question from the November 2016 Board meeting. Board will take under advisement at the next meeting. 12. Mark Boles, MD, requested his Public Orders be removed from the Board website. Dr. Retterbush motioned to deny request. Dr. Weil seconded the motion and it carried unanimously. LICENSURE COMMITTEE Dr. Retterbush presented the Licensure Committee report as a motion. The Board accepted the report by unanimous vote. The Board took the following actions:

Petitions to Waive Rules 1. Carlton R Vollberg 360-2-.01(f) & (g) Approve 2. Marite Campos 360-2-.02 Approve 3. Kiat Chan 360-2-.02 Approve 4. Michael Perkel 360-2-07(3) Table 5. Mohi Eldin, Adel 360-2-.01(1)(f) Approve



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6. O'Brien, Daniel July 2017 Board denied waiver request for support to sit for USMLE steps 1&2 exams again. Requesting that the Board reconsider.

Uphold previous denial

7. Anderson, Grecori Requesting copy of his application file to be sent to hospital for credentialing

Release documents according pursuant to O.C.G.A. §43-1-2(k)

Other Business: 1 Rule 360-2-..02 - Refer recommendations to Rules Committee. 2. Approved Questions to be added to the physician application. Are you ABMS certified? Yes No If yes, are you enrolled in MOC? 3. MS - Offer Administrative Physician license or CSE. 4. BB - Deny 5. HT - Grant 30-day extension or consider Administrative Physician license. 6. DP - Interview. 7. AM - Interview. 8. RM - Interview. 9. SD - Issue Administrative Physician license Refer to Rule 360-2-.15 re CME requirement and converting a Administrative Physician License to a full and unrestricted license. 10. CK1 - Table 11. NG - Approved to license with Consent Order, 12. CK2 – Table – Refer to Wellness 13. KB – Table 14. JL - Table and refer to Wellness and GA PHP. 15. BS -Table and refer to Wellness and GA PHP 16. JC - Table 17. AS -Table 18. JH - Reinstate with Consent Order. Approved the following applications for reinstatement of physician licensure by administrative action:

LIC_NBR NAME 14608 COHEN, RICHARD WILLIAM MD 14994 CABRERA-MENDEZ, FABIO MD 26690 WOLFF, MICHAEL HARRIS MD

28486 AGBUNAG, MELODY ANNE SANTOS MD

31830 SHIELDS, GREGORY WILLIAM MD 32195 GONZALEZ, EMILIO BUSTAMANTE MD 36578 MOMAH, DENNIS SOMTO MD 44441 DAVIS, TIMOTHY PHILLIP MD 45363 WESTON, BURT MD 45913 PHILIP, ABRAHAM T DO 46078 DOONQUAH, KOFI ADELEKE DO



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49424 MAZZELLA, FERMINA MARIA MD 49607 FARRAYE, MARC JOSEPH MD 52607 NELDER, DOROTHY KAREN MD 53570 KELLEY, RAYMOND SCOTT MD 54620 MCALARNEY, JONAS JOSEPH MD 58455 CRAWFORD, CLIFFORD (RNST) MD

61462 KAMBHAMPATI, KRISHNA KISHORE MD

61516 SAMI, FAISAL ABDUS MD 63215 ROTHPEARL, ALLEN MD 64863 MICEK, TIMOTHY JOHN MD 65518 WRIGHT, VIRGINIA FREDERICKA MD 68185 MOMIN, MOHAMMEDKOMEL MD 69565 CLARK, KUDIRATU ARANMOLATE MD 71476 CAZENAVE, BETHANY ANN MD 72935 TAYLOR, HERMAN ALFRED JR MD 74246 HARRIS, MATTHEW EARL MD 74258 CARPENTER, COURTNEY ANNE MD 74872 KENNEALY, JAMES ANDREW DO

Approved the following applications for initial physician licensure by administrative action:

LIC_NBR NAME Degree 78056 WAGNER, WILLIAM MD 78623 FISHER, ANGELA COWART MD 78624 GALIFIANAKIS, CONSTANTINE MD 78625 GANDRA, SUKUMAR MD 78626 GHOSH, BITAN MD 78627 GIBBS, JEFFREY TAYLOR MD 78628 GOODNO, HARRISON B MD 78629 GOPURALA, BALAGANESH MD 78630 GUPTA, JYOTI MD 78631 GORE, RYLAND J MD 78632 MUREMA, IRENE CHIKU MD 78633 STEVENS, LEIGH ANN MD 78634 DHARIWAL, NERLYNE KAUR MD 78635 LE-BERT, GEORGE GLENN DO 78636 DHOKE, SHEETAL MD 78637 KUMAR, VIPAN MD 78638 ADAMS, JESSICA SALEM DO 78639 ARORA, NAVEEN KUMAR MD 78640 QUATRO, RAYMOND THOMAS MD 78641 PATEL, SAMIR BALWANT MD 78642 ROMERO, WILLIAM HONORATO MD 78643 PUJARA, SHREYA MD 78644 SKIPPER, JONI BYRD MD



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78645 THOMPSON, JOHNATHAN HEATH DO 78646 UDOBI, KAHDI MD 78647 REBEIL-DELAROSA, JOSE MD 78648 RIKABI, KHALED AHMED MD 78649 ABDEL-RAOUF, AHMED M MD 78650 BERGERON, KIMBERLY GREEN MD 78651 COTLER, ALAN NATHAN MD 78652 DENNING, TATIANA DO 78653 EDAVETTAL, MATHEW MD 78654 FARMER, KIMBERLEY JANET MD 78655 SHEPHERD, APRIL MD 78656 DUCHICELA, KEEGAN AUTACHI MD 78657 KINCHEN, ERNEST W III MD 78658 LOSASSO, CARL JUDE MD 78659 KIM, BERNARD MATTHEW MD 78660 MINVILLE, JACQUES H MD 78661 SHANTHA, JESSICA GOWRAMMA MD 78662 DELAPLANE, DAVID ROBERT MD 78663 STONE, BRADLEY ALLEN MD 78664 ZEBALLOS, TATIANA MILENKA MD 78665 HANISEE, MARY KATHRYN MD 78666 JACK, AVANELLE MD 78667 MEMON, ABEER MD 78668 KATZ, DAVID EZRIEL MD 78669 HOLZ, SIEGFRIED MD 78670 MAY, ESTELLE MD 78671 LINAM, LEANN EGGERS MD 78672 HUGHES, GEORGE MD 78673 LEE, JI YEON MD 78674 LINAM, WILLIAM MATTHEW MD 78675 LOVENVIRTH, WENDI JENNIFER DO 78676 MITCHELL, BRADFORD LYLE MD 78677 KANG, MOHLEEN MD 78678 MOONEY, MELANIE LEE MD 78679 NWASIKE, CHINYELU MD 78680 SHAH, PAREEN MD 78681 EL-SHEIKH, OMAR MAHMOUD MD 78682 JOHNSON, ERICA MONIQUE MD 78683 ABOU-MEDIENE, SHARIFA M MD 78684 LEVEY, RYAN S MD 78685 GONZALEZ DE PENA, REYNALDO MD 78686 ALI, SAIMA MD 78687 THEISEN, JOHN GRAHAM MD 78688 HASSAN, SHERIF GALAL MD 78689 STUCKEY, MARK WITHERS MD



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78690 PENSO, CHRISTINE ARETY MD 78691 DUNCAN, KARA LEE MD 78692 LEBOYD, HENRY III MD 78693 REDDY BEZWADA, SRAVAN MD 78694 PRABHAKAR, AMIT MD 78695 TINTNER, RON MD 78696 WANG, CLIFFORD TAU MD 78697 WEAVER, COURTNEY JO MD 78698 RIEDESEL, ERICA LYNN MD 78699 NLEWEM, CHIMEZIE OBINNA DO 78700 HYUN, JAMES YOONSANG MD 78701 ANYOKWU, OKAH JUSTIN MD 78702 BURKE, CORRIE ANTOINETTE MD 78703 CHAN, AUSTIN WEI-HONG MD 78704 DADABHAI, ALIA SIMJEE MD 78705 LATONI, JORGE D MD 78706 SADAN, OFER MD 78707 HETMAN, ANDREI YERIK MD 78708 POWELL, LAUREN W MD 78709 ZAMAN, SAIF ULLAH MD 78710 WILKINSON, TRAMAINE MD 78711 SRINIVASAN, SHEILA YAMINI MD 78712 MCCLEAR, SHEREE MD 78713 MONNIN, KIMBERLY ANNE MD 78714 JANJUA, KAMRAN RAFIQUEE MD 78715 HANNAH, BONNIE PATRICK MD 78716 HEADRICK, JENNIFER LYNN MD 78717 FINAZZO, JOSEPHINE JOANN DO 78718 BOOTH, LAURA ASHLEY MD 78719 DELLORSO, SCOTT MICHAEL MD 78721 ABERNOT, MONICA MD 78722 DOVICH, JESSE ADAM MD 78723 PEDERSEN, DANIEL DO 78724 PERRIN, ANTHONY DO 78725 RITCH, MARK L MD 78726 REZAC, KYLE ANDREW DO 78727 SWABY, JASON A MD 78728 SANTA CRUZ, ROBERT WILLIAM MD 78729 SACKROWITZ, RACHEL EMILY MD 78730 SAKLA, ANDREW SHAKIB DO 78731 SANDERS, BRIAN PENNER MD 78732 STODGHILL, KRISTIAN HOLMES MD 78733 STRAUSS, BENJAMIN RAYMOND MD 78734 STEARS, ROBERT LEBARON MD 78735 WEST, KRISTIN MD



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78736 YU, KEWEI MD 78737 TRIVEDI, SHIVIKA MD 78738 YOWELL, CHARLES WARREN MD 78739 PATEL, CHINMAY M MD 78740 WEIR, EDWARD G DR MD 78741 WILLMAN, JOSEPH HOWARD MD 78742 YOCHELSON, MICHAEL ROBERT MD 78743 WILLIAMS-VAUGHN, IMANI MD 78744 KRANZ, ANDREI MD 78745 ADAMSON, PAULA GERTRUDE MD 78746 AMICO, FRANK J DO 78747 BANJOKO, OLUFEMI MD 78748 BARDELOZA, KAYE B MD 78749 ALMESTADY, RAJAA MD 78750 BELL, SHELANDRA SHARVONNE DO 78751 BENNER, ALISHA MD 78752 BERNS, DAVID HERSCHEL MD 78753 REDDY, HIMA MD 78754 BHAT, ARVIND MD 78755 SMITH, LARA ENID MD 78756 BLANKENSHIP, WILL OWEN MD 78757 BLUM, WILLIAM MD 78758 SMITH, ANGELA DORMAN MD 78759 STEWART, ZACHARY ELIJAH MD 78760 BRANDT, JENNIFER ELIZABETH MD 78761 BUTLER, PORSHA REGINA MD 78762 CARROLL, SARAH JAYNE MD 78763 CHARY, ARON KANDALA MD 78764 CHAUDHURI, MUNIR MD 78765 COUNSELL, STEVEN RAYMOND MD 78766 DRAPER, ERIC MD 78767 DUGGAN, LORETTA MD 78768 DUNCAN, ERIN MD 78769 FOSTER, JAMES NORMAN MD 78770 GARLAPATI, VINAY MD 78771 GILLIAM, DANIELLE NICOLE MD 78772 GINGRAS, JEAN-MARTIN MD 78773 GOODNO, AMANDA MD 78774 ABUTALIB, SYED MD 78776 KOBER, MARY-MARGARET MD 78777 KHANNA, NIDHI DO 78778 KEELEN, GREGORY MARTIN DO 78779 KASHMER, DAVID MATTHEW MD 78780 KWAN, SIMEON DO 78781 KOLAKALAPUDI, PAVANI MD



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78782 KAJI, SANJAY BANKIM MD 78784 KEATON, AMELIA ANNE MD 78785 KHANDELWAL, GAUTAM MD 78787 BENJAMIN, JOHN MD 78788 KIM, SAMUEL A MD 78789 LLOYD, CYNTHIA JO MD 78790 LUKOWSKI, ZACHARY LEE MD 78791 MASHCHAK, CLARISSA ANN MD 78792 LEWIN, MARC ROY MD 78793 SEBASTIAN, SANTHRA DO 78794 SCHNEIDER, JANEL MD 78795 TREVIL, ROBINSON DO 78796 DYER, JOSEPH MICHAEL DO 78797 NELSON, BRYANT MD 78798 MARTIN, CRYSTAL DENISE MD 78799 ESELGROTH, STEPHAN FREDERICK MD 78800 KHALID, IMRANA MD 78801 MURUDKAR, PREETI MEGHNATH MD 78802 WECHSLER, STEPHANIE BURNS MD 78803 WRIGHT, TYLER MURPHY MD 78804 AGBONYITOR, MAWUENA MURIEL MD 78805 CRAWFORD, ROBERT STUART MD 78806 CARROLL, PATRICK SIMEON MD 78807 WILLIAMS, BRETT STEPHAN MD 78808 ESPINOSA, AMY PERRILL MD 78809 SCOTT, DANIEL JONATHAN MD 78810 LI, YIBING MD 78811 OSAWE, OBOSA MD 78812 JOHAL, GURPREET SINGH MD 78813 L'ITALIEN, ANITA JO MD 78814 NORRIS, JOHN RANDOLPH MD 78815 OKAFOR, HENRY T MD 78816 MCCUTCHEON, JOHN BATES MD 78817 MUNNINGS, CORINE MARIE MD 78818 MURRAY, BRIAN P DO 78819 MOORTHY, GHURULAKSHMI MD 78820 MOHANDAS, APPESH MD 78821 MURTHY, RAJINI KRISHNA MD 78822 MEREDITH, GARY EUGENE MD 78823 MISIASZEK, RICHARD MD 78824 MATTA, STEPHEN SHOUKRY DO 78825 MASILAMANI, SANJAY MD 78826 MARSHBURN, REBECCA MD 78827 MITCHELL, JUSTIN LEE MD 78828 DE LIMA, MARIA HELENA MD



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78829 ISMAIL, INZHILI KENAN MD 78830 MAHESHWARI, SHWETA N DO 78831 JONES, NORMAN ALEXANDER MD 78832 HO, WAYNE MD 78833 HITCHCOCK, THOMAS DO 78834 HABIBULLAH, MASUD HASSAN MD 78835 HENDERSON, JOHN HORACE IV MD 78836 HINES, RANDY TODD II MD 78837 HUDSON, ZACHARY DEREK MD 78838 HAGOPIAN, TARA DO 78839 HOEHN, MELANIE ROSE MD 78840 MORI, NEIL MD 78841 KOKILAKUMAR, PRANAM MD 78841 KOKILAKUMAR, PRANAM DO 78842 HINES, TOMIA BIANCA DO 78843 ALVAREZ LEON, MARISOL MD 78844 BEST, MICHAEL WARREN MD 78845 BUTLER, ALEIYA JUSTASIA MD 78846 CHENAULT, CARRIE BESS MD 78847 ELLISON, STEPHEN RUSSELL MD 78848 FU, PING MD 78849 WESTERMAN, STACY MD 78850 WEIBKE, KRISTY MD 78851 PEVSNER, DEBORAH MD 78852 SCOTT, FRANK DUNCAN MD 78869 TORO, JAIME MD 78869 TORO, JAIME MD 78870 ZIMMERMAN, JENNIFER DO 78870 ZIMMERMAN, JENNIFER DO 78871 VEGA, ALEJANDRO MD 78872 WINDSOR, JOHN DO 78872 WINDSOR, JOHN DO 78874 PORTER, JOHN MD 78876 BEER, SARAH MD 78878 COURTNEY, RICHARD MD 78879 MCLENDON, JEANNA MD 78879 CRUZ, HERBERT MD 78880 DAVIS, LEON MD 78881 EISEN, ALEXANDER MD 78883 MCLENDON, JENNA MD 78884 KALMUK, EUGENE MD 78885 HERNANDEZ, JOSEPH MD



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NURSE PROTOCOL COMMITTEE Dr. Callins presented the Nurse Protocol Committee report as a motion. The Board accepted the report by unanimous vote. The Board took the following actions: Found that the following protocol agreements meet the provisions of OCGA 43-34-25: APRN DELEGATING PHYSICIAN

Abiri, Autherine Hardy, Susanne, MD Adderly, Kisha Adofo, Margaret

Hood, Crystal, MD Kelly, Patricia, MD

Adjei, Vincentia Gavrikov, Vitaliy, MD Allen, Renai Thomas, Thomas, MD Amdrews, Ashley Piya, Anil, MD Amos, Karen Taiwo, Olufemi, MD Amougou, Yves-Aime Sewell, Vanderlyn, MD Apara, Margret Johnson, Kevin, MD Azad, Farjana Baker, Benjamin

Sagel, Anthony, MD Watkins, Kevin, MD

Banugaria, Bhumika Murimi, John, MD Baptiste, Gina Valancius, Daniel, MD Barbee, Kimberly Battaglia, Emily Beasley, Kitty

Harper, Fitz, MD Hutchinson, Amanda, MD Ukaonu, Anozie, MD

Beasley, Melissa Prasad, Vijitha, MD Beck, Stacy Ussery, Charles, DO Beck, Stacy Agrawal, Pankay, MD Benefield, Kristin Hall, Heather, MD Berry, Crystal Fortson, Michael,,MD Berry, Jasmine Besse, Jennifer

Francis, Gweneth, DO Hutchins, Jessica, MD

Bonilla, Beverly Chay, Wesley, MD Borders, Amber Griffiths, Mark, MD Bowers, Jessica Sewell, Vanderlyn, MD Boyd, Jason Gaskins, Johnathan, MD Braaten, Rachael Harper, Fitz, MD Brisibe, Modupesla Odemui, Abdul, MD Bunker, Kimberly Agrawal, Pankay, MD Burke, Sadie Hatfield, Jackson, MD Burris, Robin Cantrell, Forrest, MD Cadet, Jean Norniella, Roberto, MD Cannington, Sara Spencer, Dennis, DO Carpenter, Deborah Freeman, Neale, MD Carter, Shanda Irwin, William, MD



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Chase, Kelly Ward, Jeffery, MD Chase, Lana Hill, Walker, MD Chatman, Shannon Hanser, Terry, MD Cheeks, Mackenzie Cheves, Harry, MD Cliett, Raina Reddy, Rani, MD Cochran, Charma Wilson, Mitchell, MD Cordi, Francesca Chandan, Sushma, MD Crum, Taylor Garcia, Alberto, MD Cueto, Jonathan Beckford, Rita, MD Curry, David Reardon, Roy, MD Daly, Michael Bennett, John, MD Davis, Candis Thacker, Betsy,MD DeBerry, Ashley Cot-Puckett, Wendy, MD DeLoach, Shana Barger, Robert, MD Demott, Jennifer Richards, Kimberlynn, MD Diaby, Nassaratou Sewell, Vanderlyn, MD Douthit, Melissa Brahman, Parviz, MD Doyle, Erica Mcgrory, James, MD Duane, Danielle Fortson, Michael, MD Durden, Debra Scanlon, Robert, MD Ejimofor, Kelech Nwaobi, Ike, MD Ellis, Sarah Womack, Rosalind, MD Emmanuel, Roselande Antoine, Patrick, MD Enworom, Chinyere Reddy, Satyanarayan, MD Ernest, Audra Puppala, V.K, MD Eziakor, Chiazor Ezell, Rachel

Ajayi, Edward, MD Davis, Mitchell, MD

Fareed, Surayyah Sonyika, Haiba, MD Floyd, Christopher Kaiser, William, MD Garrett, Tracy Torres, Rolando, MD Garrison, Margarita Fortson, Michael, MD Giardina, Julie Dasher, Glen, MD Gilfillan, Kelly Sewell, Vanderlyn, MD Gleckler, Ehren Scholossberg, Richard, MD Gonzales, Christy Davis, Jeff, MD Graham, Sherome Feinstein, Trevor, MD Greear, Ellen Lukose, Ludy, MD Green, Rebecca Davis, Lawton, MD Hall, Marylin Harrell, Roy

Anander, Steven, MD Kahn, Neil, MD

Hill, Cara Renigfo-Moreno, Pablo, MD Hill, Collie Mitchell, Davin, MD Hoefs, Jamie Norniella, Roberto, MD Holley, Nelda Logendra, Narendra, MD Hong, Michelle Herrera, Robert,,MD Hosang, Michelle Rashid, Qammar, MD Howell, Charlotte Chowdhury, Zahidul, MD



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Howell-Philip, Vanessa Harris-Moore, Karen, MD Hughley, Rhonda Lasher, Jr., Sstephen, MD Hunter, Kristin Kidwai, Asim, MD Irwin, Christine Jefferson-Saboo

Jones, Barry, MD Van-Horn, Andrew, MD

Jefferson, Khara’ Harris, Rashante, MD Jenkins, Catherine Jones, Jefferson, MD Jones, Anna Reinhardt, Cheryl, MD Jones, Kyle Kozinn, Spencer, MD Kaimachiande, Finda Young-Wilson, Crystal, MD Kargbo, Isatu Freeman, Neale, MD Kemp, Haley Barczak, Brian, MD Kent, Misty Currier, Steven, MD Knight, Nicole Kolleda, Kimberly

Mitchell, Davin, MD Pham, Nga, MD

Kobia, Sonya Burney, Nitasha, MD Krummel, Nicole Patel Piyush, MD Kyzer, Fraulein Roberts, Michael, MD Lanier, Erica Miller, Thomas, MD Leffall, Para Chowdhary, Zahidal, MD Love, Sheila Baker, Karen, MD Lovell, Jennifer Ragan, James, MD Lyman, Pamela Howard, Brian, MD Malik, Tasneem Marshall, Damali Mallett, Nina Martin, Cecile

Nguyen, Dich, MD Morgan, Mae, MD Patrick, Kenneth, MD Crocker, Bobby, MD

Mason, Patricia Gaskins, Johnathan, MD McCoy, Labraile Verdun, Joseph, MD McDade, Laura Musey, Victoria, MD McDonald, Karen Keller, John, MD Meadows, Kendaly Harbett, Esthe,r MD Meighan, Lisa Mena, Jorge

Cabrera, Cynthia, MD Franco, Carlos, MD

Menjivar, Jorge Labady, Antony, MD Merck, Linne Miranda, Kristen

Haddad, Pryham, MD Miranda, Paul, MD

Mody, Bela Lee, James, DO Moody, Duane Parry, Scott, DO Morton, Virginia Jenkins, Francis, MD Mower, Emily Moore, Robert, MD Mower, Emily Moore, Robert, MD Mullis, Lori Warnock, Ralph, MD Narmani-Muhhadi, Foroogi Darji, Jaykrishan, MD Netrow, Mary Camacho, Salvador, MD Northcutt, Torree Gerguis, Angela, MD Nwogu, Cecilia Fiakpornoo, Sylvanus, MD



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O’Berry, Gabrille Ellis, Shannon, DO Oga, Kristin Ohawa, Joan

Lloyd, John, MD Stubbs, Migue,l MD

Oparah, Theresa Epstein, Benjamin, MD Orabueze, Ngozi Hud-Aleem, Raushanah, MD Ozim, Maureen Hill, Walte,r MD Ozim, Maureen Jingo, Ahmad, MD Pass, Sherry LaFontaine, Stephanie, MD Pate, Erin Perry, Tracy

Virgil, Teddi, MD Long, Mark, MD

Perkins, Nekey Scott, Alan, MD Peters, Katherine Chervu, Arun, MD Peterson, Rachel Moss, Michael, MD Powell, Silona Harris, Rashante, MD Price, Paula Pruett, Meagan

Hendricks, Edwin, MD Meachan, Lillian, MD

Raparla, Amor Bradshaw, Mark, MD Raparla, Amor Bradshaw, Mark, MD Raulin, Helen Greaves, Paula, MD Redjamond, Mojgan Kim, Jeffrey, MD Regan, Kiara Feldstein, Richard, MD Reuter, Peters Caples, Sean, MD Robertson, Emily Turner, Karen, DO Robinson, Marianne Robertson, James, MD Rose, Karen Lee, James, DO Rubio, Pamela Sapoznick, Scott

Destito, John, DO Thourani, Vina,l MD

Samter, Jeanne Nassif, Walid, MD Scott, Tonya Sherman, Carmen

Gilhuly, Michael, MD Okwumabua, Isioma, MD

Simmons, Trevino Sewell, Vanderlyn, MD Smith, Chasity Forgay, Andrew, MD Smith, David Blake, Wyat, MD Smith, Kerry Brown, Daniel, MD Smith, Leslie Cruz, Martinez, MD Smith, Nicole Heath, Robert, MD Smith-Bowles, Marilynn Sarin, Sanjay, MD Sullens, Amy Satterfield, Grova, MD Swindell, Jessica Kukocka, Slavko, MD Tant, Aubrea Goolsby, Carl, MD Taylor, Delisha Machado, Claudio, MD Taylor, Dwanye Datta, Sandeep, MD Thomas, Megan Garst, Steve, MD Thompson, Joyce Tarcoronti, Rudolph, MD Walden, Zachary Javed, Tariq, MD Walker, Tasha Braun, Nohl MD Walters, Roberta Mohan, Amar, MD



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Watson, Kenya Antonio, Richard, MD Watson, Trenton Chang, Sung, MD Webb, Leah Cruz-Martinez, Drisde, MD Welch, Lanie Welch, Natasha

Davis, Jeffrey, MD Bennett, Myla, MD

Wellman, Kristin Kirsch, Andrew, MD Welsh, Tiaya Smith, Michae, MD Werner, Melody Chaudhury, Zahida,l MD Weston, Erin Antonio, Richard, MD Wightman, Heidi Caples, Sean, MD Williams, Natasha Harrigan, Mar, MD Williams, Shirley Bent-Harley, Sharon, MD Williams, Tamika Xia, Tia, MD Wilson, Deborah Woods, Jennifer

Hodges, Fred, MD Thurman, Lavo, MD

Yonchik, Christina Young, Angelique

Graham, Fitzroy, MD Verdun, Joseph, MD

Found that the following protocol agreements meet the provisions of OCGA 43-34-25 with additions/changes: APRN DELEGATING PHYSICIAN

Adofo, Margaret Kelly, Patricia, MD Bolton, Tracy Rich, Patrici,a MD Bremer, Erin Iftikher,Imran, MD Cato, Kayla Ogunidipe, Akinkunwi, MD Connors, Julie Meng, Yuan-Xiang, MD Dankyi, Edward Yahanda, Allen, MD Dominquez, Christine Locker, Kathleen, MD Dyches, Rachel Patel, Hitendra, MD Ford, Gina Fagan, Melissa

Self, Thomas, MD Kelly, Patricia, MD

Goldstone, Elaine Afridi, Zahid, MD Holiday, Demetrius Hazen, Matthew, MD Irwin, Christine Jones, Barry, MD Jeffries, David Yen, Andrew, MD Johnson, Robert Little, Lawrence

Figgueroa, Cesar, MD Durham, Megan, MD

Mayover, Laura Bennett, Pete,r MD Otubaga, Omolola Cooper, Douglas, MD Pruett, Megan Meacham, Lillian, MD Simpson, Rebecca Leimbach, Mark,MD Thomas, Charmaine Childs, David, MD Tyner, Carrie Nguyen, Jacqueline, MD Williams, Lucas Staton,George, MD



16

Wright, Lorie Brown, James, MD

Other Business:

1. Discuss requirement for agreements that reflect telemedicine services being provided. Table for further information.

2. Can APRN’s issue DNR orders?

PHYSICIAN ASSISTANT COMMITTEE Dr. Antalis presented the Physician Assistant Committee report as a motion. The Board accepted the report by unanimous vote. The Board took the following actions. Approved the following applications for initial licensure with a supervising physician: PA Supervising Physician

Austin, Holly Lynn Rollins, Chester P. Burt, Brandon Alan Barbour, Scott Allen Cunningham, RobertM. Kolovich, Gregory Paul Harris, Emily Sain Sancheti, Manu Suraj Hauff, Victoria Arasi, Richard Ho, Lisha Sheng Kooby, David Abraham Kirby, Meghan Nicole John, Edsworth S. Lunsford, Jacob Ryan Sleigh, Bryan Charles Moore, Alexandra Jamila Visitacion, Maria Clarissa Lorete Tanner, Stacy Sanders, Andrew C. Tekin, Kristen Clark Shack, Richard Keogh Jr

Approved Applications for initial licensure without a supervising physician: PA Austin, Tamara Denine Chervil, Sheila Brun Craven, Scott Wesley Davis, Latera D Diaz, Gustavo Adolfo Dunn, Meredith Ann Harrell, Hannah Renee Rains, Jay Richards, Stephanie Stephany, Christopher Steven

Approved the following application for reinstatement with a supervising physician pending additional information: PA Supervising Physician Purser, Brian Gary Pritchett, Jennifer C



17

Approved the following Add/Change applications: PA Supervising Physician Alston, Sharon M 2667 Bennett-Johnson, Dianne J 37957 Anderson, Adrienne W.

8289 Lafosse, Vera 75308

Anderson, Lorenzo J 5655 Edjua, Paul Avayonde 62972 Anyanwu, Chiedozie 8273 Towater, Laura Jean 65802 Artman, Tiffany L.e 3357 Howard, Selwynn Bryan 45829 Baker, Janna Leigh 6974 Ashford, Sarah Elizabeth Bailey 74804 Banks, Melanie 4518 Fisher, Micah R 56546 Biron, Edwina W.d 1987 Carter, David James 77979 Bleakley, Elizabeth 6700 Holmes, Thomas M 57085 Brown, Jennifer 7833 Allen, Julie 72884 Bruniera, Tiago P. 7644 Stouffer, Chadwick William 74786 Caraviello, Harold E Jr

2257 Wrobel, Peter 40285

Carney, Kathryn P.. 5685 Tally, William Carlton 59776 Carter, Christopher M.

2277 So, Laurence 72131

Caviness, Stephanie G.

6430 Bennett, Ray B 56526

Caviness, Stephanie Greathouse

6430 Greening, Billy Eugene 42585

Cheng, Minder 4141 Odame, Isabella Zita 77276 Choi, Amanda Ann 7132 Mcalvany, William Price 31625 Clark, Laurie D. 6357 Wilson, Bryant Whitley 29824

Clayton, Tyger C. 7397 Harris, Diane Elise 66500 Collins, Justin M. 6573 Tanguturi, Sriharsha Sriniv 61667 Didier, David 4999 Malebranche, David

Joseph 50223

Douglas, Caroline L. 5678 Lister, Debra Elaine Bearden

38849

Drobka, Sarah Elizabeth

8138 Speaks, Allyson Wells 72451

Dugan, Shannon C 6044 Miller, Joseph Irvin Iii 45892 Emineth, Wayne A 4308 Forney, Virginia Rutledge 44218 Eshleman, Brandon Lee

6606 Crumbley, Audrey Shields 53031

Everett, Sarah Katherine

6098 Stouffer, Chadwick William

74786

Fadoju, Olufunke Ellen

6359 Shikh, Charanjit Singh 37451

Ferrer, Noel 7804 Roffwarg, David Elliott 77405



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Forrester, Michelle Conklin

5879 Dourron, Rodney Michael 36143

Gibson, Janai L 7456 Durden, Frederick Letois Jr 65539 Gilley, Pamela S. 8122 Allen, Jonathon C 56949 Goodchild, Charleen C.

8208 Charbonneau, Eugene George

73481

Gordon, Heather 6024 Edens, Christopher Alton 42042 Graeber, John Jr 6914 Ryan, Ashley 63949 Grissom, Sarah E.h 8426 Denman, David Allen 46538 Hall, Morgan Janelle 8242 Speaks, Allyson Wells 72451 Hartle, Stephen C 7350 Ganjam, Satishkumar 61583 Hawkins, Stephanie K.

4719 Baumgarten, Deborah Ann 33931

Heimbecker, Molly 7569 Sobel, Kenneth Jay 24099 Heinsch, Stephanie N. 8223 Edens, Christopher Alton 42042 Isett, Raffaela Rosa 5860 Galan, Vincent 28685 Johnson, Ashley F. 6845 Dunaway, James Boyd Jr 31588 Johnson, Colin W. 8391 Singh, Arvinpal 50772 Johnson, Justin M. 8153 Allen, Julie 72884 Johnston, Courtney G. 8147 Agha, Syed Abbas 59357 Kaszak, Melissa 8155 Speaks, Allyson Wells 72451 Keats, Michael D. 5912 Cox, Cristalle 73162 Kimsey, Elicia A.P.n 5723 Barnes, Alan Michael 72678 Knight, James Kent 3163 Ryan, Ashley 63949 Kooy, April 6078 Shikh, Charanjit Singh 37451 Krupansky, Craig 7093 Harris, Rashante 62706 Lal, Chhavi Ahooja 4153 Juneau, Michelle Leigh 63359 Lane, Kevin A., Sr. 2999 Nwabueze, Eni

Chukwuemeka 42377

Leduc, Marc 6988 Groves, Michael William 65664 Lesoon, Leslie Ann 7744 Mcdonough, Colleen Hope 56153 Ludwig, Raquel V. 6149 Goodman, Marcus Brian 64221 Lytle, Nicole Alicia 3771 Brown, Russell Edward 39743 Marrero, Lisa Dawn 5643 Callahan, Nadine Marie 73246 Matte, John M 7936 Geldres, Juan 66492 Mcdonald, Cynthia J 3764 Bennett, Ray B 56526 Mink, Kristin Cerise 5047 Rene, Sabrina M. Y. 46560 Monroe, Mary 8392 Lichtenstein, Jason Barry 62058

Moore, Aubrey G. 1560 Lee, Clay Andrew 46610 Mora, Joanne 7808 Mehta, Jyotir K 45887 Moss, Heather M. 5518 Allen, Jonathon C 56949 Muller, Brooke A. 8224 Kashyap, handrashekar 77635 Murphy, Thomas A. 5795 Blake, William T 46041 Ncho, Clement A 6000 Edjua, Paul Avayonde 62972



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Nguyen, Karen 7753 Shih, John Yozen 38091 Nowlin, Amy G 7409 Hall, David Lee 38791 Pacheco, Allison F. 3734 Mulloy, Laura Lyngby 33412 Paige, Elizabeth A. 8032 Henson, Michele Renee 73306 Pancoast, Erica L. D. 6080 Bradbury, Thomas Lane 59130 Patel, Anilkumar P 7949 Patel, Anilkumar P. 33774 Peck, David Robert 5607 Fisher, Stephen Ronal 62037 Phillips, Heidi N. 7612 Ward, Martha Susan 20360 Pippin, Sheila D. 5447 Wallace, Timothy Brian 27684 Roberts, Billy E. 904 Sexson, James Allen 38362 Robinson, Terry L. 3629 Felton, Stephen Frank 30996 Roby, Benjamin M. 8345 Clayton, Mitzi M 61408 Rowe, Jennifer J. 8206 Allen, Jonathon C 56949 Sackariasen, Phyllis W. 2147 Zimmerman, Anne C. 70612 Santos, Jenny C. 8347 De Leon, Fidias Eduardo 63891 Saucier, Abigail A. 8210 Bowman, Mac Andrew 21647 Scott, Melinda 7421 Westenbarger, Richard Lee 62090 Sexton, Sarah Lynn 8312 Carroll, Kelley Walk 78264 Shah, Sonia 8432 Hood, Fred Kennard 45071 Shaikh, Vaseem 7769 Burch, Jason Edward 77661 Shibley, Michael V. 6164 Lloyd, Edward Allan 44269 Shuff, Jesse Paul 6958 Johnson, Ryan P 56876 Simone, Amy E. 5427 Guyton, Robert Allan 21240 Smith, Jawauna M. 6455 Sanders, Roy Quincy 50837 Stansell, Christopher A. 5105 Bailey, Jonathan 76940 Stone, Miranda O.r 7482 Lafosse, Vera 75308 Stout, Bobby Gene Jr 3770 Hayat, Khalid J 56555 Swicegood, Brittany S. 8028 Martin, Garland Leon 47233 Thompson, Abigail B. 7431 Daisy, Christopher Patric 71663 Traenkner, Jessica J. 7945 Fioranelli, Barry Allen 41793 Tran, Tam Hoang 6554 Ward, Jacob Tucker 32075 Wall, Freda Ellen 2766 Musser, Daniel J 76582 Weeks, Morganne M. 6807 Gates, Donald Lyle 53915 Wilburn, Caitlin Ann 7817 Davis, Reginald Maurice Jr 27720 Wilkins, Ashley B.e 8315 Patel, Birju Bankim 51706 Williams, Lynne B. 6559 Bosch, Ortelio 51119 Willis, Paula S. 3144 Kornblatt, Brian Jay 38029 Wood, Lacey Elaine 8316 Nwaobi, Ike Anthony 65038 Zamani, Rad 4905 Callahan, Nadine Marie 73246 Zamani, Rad 4905 Cox, Cristalle 73162 Zenebe, Masresha 4711 Malebranche, David

Joseph 50223



20

Approved the following Additional Duties Request: PA Supervising Physician Stacey Philp PA-C Dr. Marcus Sims Cardiac Stress Testing with and without Nuclear Imaging Invite for Interview: M.J. J.P. S.H. H.W. Other Business: 1. W. S - Tabled application for initial licensure without a supervising physician, for additional information. 2. K.P. - Denied request to change shadowing hours. 3. N.E. – Refer to Enforcement. 4. 20180194 – Refer to Enforcement for reinstatement with a Consent Order. 5. David Siegel - Refer to Georgia Composite Medical Board rules and laws for reinstatement.

COSMETIC LASER PRACTITIONER COMMITTEE Dr. DeLoach presented the Cosmetic Laser Practitioner Committee report as a motion. The Board accepted the report by unanimous vote. The Board took the following actions: Approved the following applications for Assistant Laser License:

Jemilla Banner Stephanie Basile Brittany Craig Baylee Crumpler Christine Eaton Beverly Francis Terrelle Hunt Beverly Hutchinson Kelsey Poteet Hailey Queen Venus Spivey Cecilia Thompson

Approve the following Senior Laser Practitioner applications for licensure: Ansley Branch, Senior LP Whitney Rapoport, Senior LP Tabled Laser Practitioner applications for licensure:



21

Sonya Gordon, interview Other Business: 1. E.T. - Tabled the following Laser Practitioner application for licensure: 2. M.W. – Send a Cease and Desist letter. 3. M.V. – Invite for interview. 4. S.G. - Table

ORTHOTIST & PROSTHETIST COMMITTEE Mr. Wallace presented the Perfusionist Committee report. The Board accepted the report by unanimous vote. The Board took the following actions: Approved the following applications for Orthotist licensure:

Mular, Laurlynn Approved application for Prosthetist licensure: DH- Reinstate license with a Private Consent Approved Orthotist and Prosthetist upgrade: Emling, Brian Other Business: 1. Approved new committee candidates, Zach Hughes and Rusty Walker to replace Jim Hughes and Todd Clay. The new members will serve a two year term, effective August 31, 2017 RESPIRATORY CARE COMMITTEE Dr. Collins presented the Respiratory Care Committee report as a motion. The Board accepted the report by unanimous vote. The Board took the following actions: Approved reinstatement applications: BURNAM, MARIAN COLBERT, ISHA JONES, RACHE pending additional information NELSON, DORINDA ORR, TOWANA REIDER, PAMELA SINGLETON, SUE WARREN, TIMMERY Approved the following applications for licensure by reciprocity pending:



22

ARMSTRONG, SUE ASHTON, MIRANDA, pending additional information BURDEN, SHARON DATSA, SELOM KOMLA FLOWERS, GAYLYNN DENISE GORDON, MONICA MARLOW, ASHLI MARIE ROCHE, PAUL S SAMPSON, RACHEL TARAKJI, MICHELLE TYRUES, DEBORAH E VAN DYKE, AMY LARIE VAZQUEZ, JESSICA WATKINS, STEPHANIE, pending additional information WEAVER, MARTA Approved the following applicants requesting a 12-month permit: ARMSTRONG STATE UNIVERSITY OWENBY, DAXON RIGHT, ELIZABETH INDEPENDENCE UNIVERSITY GOODWILL, ALYSSA MISSOURI SOUTHERN: MOMPOINT, NATALIE Ratified the following administratively approved upgrades to full RCP license: ALDER, CARLIEGH CARNES, MELANIE DRUMGOOLE, KEISHA GIBBONS, TISHIRA GILMORE, KIMBERLY LONDON, CRYSTAL R NORTHERN, STEVEN OLIVER, CLIFFORD Other Business: 1. Approved Committee to review CEUs requirements, Respiratory Care Professionals (RCPs) policy up-dates, as well as reference Forms B and make recommendation at the August 31, 2017 Board meeting. 2. Approved Lindsey Joyner‘s petition to waive Rule 360-13-.03. 3. 20180196 - Refer for Consent Order.



23

ACUPUNCTURIST COMMITTEE Dr. Downey presented the Acupuncturist Committee report to the Board as a motion. The Board accepted the report by unanimous vote. The Board took the following actions: Approved the following applications for initial licensure: George Forster

Approved the following Quarterly Report: Gina Michaels Other Business: 1. Reviewed as information —the list of limited licensees and supervisors

PERFUSION COMMITTEE Dr. Retterbush presented the Perfusionist Committee report.as a motion.. The Board accepted the report by unanimous vote. The Board took the following actions: Approved the following applications for provisional licensure:

J. Scott Dean Susanna Downing

Approved the following application for Initial licensure: Meredith Crumpler

Other Business: 1. Approved Milton Wilkes Perfusion Committee. Other Business: 1. Approved new committee candidates, Zach Hughes and Rusty Walker to replace Jim Hughes and Todd Clay. The new members will serve a two year term, effective August 31, 2017. 2. Reinstatement application will be updated to replace education requirements with CEU requirement and submitted for committee approval.Ms. Hughes will draft O&P reinstatement rules for review at August 31 meeting. 3. 20171517- Refer to investigations. 4. DH- Reinstate license with a Consent Order.

PAIN MANAGEMENT CLINIC COMMITTEE Dr. Downey presented the Pain Management Clinic Committee report as a motion. The Board accepted the report by unanimous vote.



24

The Board took the following actions:

Initial Applications Approved: File

# Pain Clinic Name

433 Arilex Medical Services, LLC

434 Pain Consultants of Atlanta, LLC-Fayetteville

435 Atlanta Sports and Spine LLC - Marietta

437 Specialty Clinics Spine Intervention - Gainesville

Change of Location and Change of Name Application Approved:

License #

Pain Clinic Name

441 Altergyn, LLC

Add/Change Application Approved:

License #

Pain Clinic Name

223 Augusta Pain Consultants

Change of Location Applications Approved:

License #

Pain Clinic Name

295 Total Pain Solutions, PC - Smyrna

399 Family First Healthcare of NE GA – Athens

Ratified the following Applications Administrative Approved License:

License # Pain Clinic Name

348 Ancora Pain Recovery Delete practicing physician Gary Theofilis

368, 369 Axis Pain Center Delete APRN Wendy Harris

284 Georgia Pain Associates, Braselton Add Physician Assistant Tam Tran



25

224 Harbin Clinic Add practicing physician Asmitha Sathiyakumar

149, 374, 437, 439

Hemlock Pain Center Add APRN Dwayne Taylor Delete APRN Torre Northcutt

279 Nexus Pain Center of Columbus Add APRN Trenton Watson

311,312, 313, 314, 435, 440

Pain Care LLC Add practicing physician Akshay Garg

225, 226, 227 Pain Management Specialists of Atlanta Add APRN Wendy Harris

234, 291 Specialty Clinics Spine Intervention Add practicing physician Brian Adams

235

Specialty Clinics Spine Intervention Add practicing physician Brian Adams Add APRN April Bussoletti

148 Suwanee Pain Management Add practicing physician Anthony Ditaranto

266

TDI Pain Add APRN Callie Hill Add APRN Nicole Knight

451

Specialty Clinics Spine Intervention Add practicing physician Brian Adams

Pain Clinic Renewal Applications

1. License #390 - Georgia Pain & Behavioral Medicine – allow 30 days to either show proof of CME or be registered for a course that must be completed within 60 days.

2. License #383 - Medici Medical Arts - allow 30 days to either show proof of CME or be registered for a course that must be completed within 60 days.

3. License #274 - South Atlanta Medical Center – approved for renewal. Other Business:

1. Reviewed letter from APW, LLC and approved to uphold the original decision with PCO/Fine. The clinic may apply for another license.

2. Fee for reinstatement of a revoked or lapsed pain clinic license will be $1200 3. Fee for reinstatement of an inactive pain clinic license will be $500. 4. Accepted as information only the letter from American Academy of Medical Acupuncture. 5. 43-34-8 which identifies the kind of disciplinary action that can be taken against a doctor. 6. License #372 - Center for Spine and Pain Medicine – approved for renewal



26

CLOSED SESSION Dr. DeLoach submitted a motion, seconded by Dr. Retterbush, to go into executive session to discuss investigative matters. Upon conclusion of the Board’s discussion of the matters, Dr. Antalis declared the meeting in open session.

LEGAL / ENFORCEMENT ACTION REPORT Mr. Reimers presented the Legal / Enforcement Action Report. Dr. Retterbush submitted a motion, seconded by Mr. Wallace, to accept the report. The motion carried unanimously. The Board took the following actions: 1. 20111442: Release investigative files 2. 20131452: Table 3. Susan Harding, MD: Terminate practice restriction 4. 20140882: Accept Private Consent Order 5. Debra Johnson-Jordan, MD: Accept Public Consent Order 6. Andrea Polk, PA: Accept Inactive Status 7. Jonathan Clifton, PA: Accept Inactive Status 8. Susan Blank, MD: Approved as OMPE Board Evaluator 9. Jason Lee Sevald, MD: Accept Consent Order 10 Peter Rizzo, MD: Accept Public Consent Order 11.20162238: Table

ATTORNEY GENERAL’S REPORT Janet Wray, Senior Assistant Attorney General, updated the Board on the status of matter that have been referred to the Attorney General for legal action. Dr. Marshall submitted a motion, seconded by Dr. Weil, to accept the report. The motion passed unanimously. WELLNESS COMMITTEE Dr. Collins presented the Wellness Committee report. Dr. DeLoach submitted a motion, seconded by Dr. Retterbush, to accept the report. The Board accepted the report by unanimous vote. The Board took the following actions:

1. PHP report received from Robin McCown. 2. 20160003 – Request for early termination of Public Consent Order granted. 3. Applicant AD – Referred back to Licensure Committee; license contingent on letter of advocacy from treating psychiatrist. 4. 20121183 – Compliance review –Lletter of Concern outlining terms of Consent Order and consequences of not complying. 5. 20161410 – Review of Attorney Generals memo regarding recommendations for an Amended Consent Order

INVESTIGATIVE INTERVIEWS Dr. Weil, presented the Investigative Interview report as a motion, and was seconded by Dr. Retterbush, The Board accepted the report by unanimous vote. The Board took the following actions.



27

20160876 Close 20161424 Further Investigation 20161491 Table – Dr. Butler recused and not present during discussion. 20170094 Letter of Concern 20170178 Close 20170440 Letter of Concern 20170260 Table 20170529 Further Investigation 20170961 Offer Inactive 20171113 Close INVESTIGATIVE COMMITTEE The Investigative Committee report was presented as a motion by Dr. Retterbush,, and was s seconded by Mr. Robinson,. The Board accepted the report by unanimous vote. The Board took the following actions. Close:

20140745 20150627 20151086 20161330 20161389 20161392 20161393 20161394 20161395 20161404 20161405 20161406 20161407 20161408 20161411 20161412 20161435 20161448 20161493 20161495 20161497 20161505 20161517 20161520 20161529 20161532 20161536 20161577 20161587 20161588 20161597 20161610 20161611 20161730 20161731 20161732 20161733 20161734 20161735 20161759 20161760 20161761 20161794 20161892 20161898 20161902 20161906 20162074 20162144 20162145 20162241 20162331 20162375 20162376 20170131 20170154 20170445 20170515 20170965 20171094 20171183 20171248 20171261 20171458 20171524 20171540 20171619 20171621 20171664 20171668 20171675 20171677 20171679 20171690 20171693 20171700 20171704 20171712 20171718 20171721 20171724 20171734 20171736 20171737 20171740 20171749 20171750 20171751 20171752 20171755 20171758 20171760 20171767 20171784 20171796 20171815 20171824 20171827 20171841 20171842 20171853 20171856 20171861 20171894 20171897 20171978 20172187 20172232 20172282 20161970 20161971 20170942 20171270 20171614 20171649 20171688 20171741 20171763 20171779 20171808 20171820 20171823 20171844 20171852 20171880

Close with Letter of Concern:

20170916 20171160 20171519 20171777 20171787 20171806 20171889 20171896 Invite for Investigative Interview: 20171622 20171670 20171768 Further Investigation 20170009 20171602 20171726 20171789 20171818



28

Table

20140113 20151050 20171427 20171762 20171797 20171865 Mirror Action from Other State

20171781

Attorney General’s Office

20172172

Peer Review

None INITIAL COMPLAINT EVALUATIONS

The Board approved the following recommendations.

20172308 20172315 20172320 20172324 20172325 20172326 20172327 20172331 20172334 20172346 20172352 20172353 20172364 20172365 20172370 20172374 20172375 20172377 20180012 20180020 20180022 20180027 20180036 20180039 20180046 20180047 20180048 20180054 20180068 20180073 20180078 20180086 RECUSALS

Collins 20171649 DeLoach 20171602 20171844 20171677 20171724 20171758 20171842 20172187 20131452 Marshall 20171740 Mohan 20171784 Retterbush 20171808 20171827 20171853 20172187 20161780 Robinson 20171160 20171602 20171622 20171779 20171844 20171852

There being no other business, Dr. Weil submitted a motion, seconded by Dr. Marshall, to adjourn the meeting. The motion carried unanimously. Dr. DeLoach adjourned the August 10, 2017 meeting __________________________________ _____________________________________

E. Daniel DeLoach, MD LaSharn Hughes, MBA Chairperson Interim Executive Director __________________________ Diane Atkinson Board Secretary

Documents

GEORGIA COMPOSITE MEDICAL BOARD · Georgia Composite Medical Board ... LaSharn Hughes, MBA, Interim Executive Director ... Patricia Sherman, Enforcement Manager